Oncologic outcome of colon cancer with perforation and obstruction

Abstract

Purpose: Perforation and obstruction in colorectal cancer are poor prognostic factors. We aimed to evaluate the oncological outcomes of patients with colon cancer presenting with perforation or obstruction. Methods: A total of 260 patients underwent surgery for colon cancer between January 2015 and December 2017. Among them, 54 patients who underwent emergency surgery for perforated (n = 32) or obstructive (n = 22) colon cancer were included. Results: The perforation (PG, n = 32) and obstruction groups (OG, n = 22) did not differ significantly in age (p = 0.486), sex (p = 0.821), tumor stage (p = 0.221), tumor location (p = 0.895), histologic grade (p = 0.173), or 3-year overall survival rate (55.6% vs. 50.0%, p = 0.784). However, the PG had a higher postoperative complication rate (44% vs. 17%, p = 0.025), longer intensive care unit stay (4.8 days vs. 0.8 days, p = 0.047), and lower 3-year recurrence-free survival (42.4% vs. 78.8%, p = 0.025) than the OG. In the multivariate analysis, perforation was significantly increased risk of recurrence (hazard ratio = 3.67, 95% confidence interval: 1.049–12.839, p = 0.042). Conclusion: Patients with colon cancer initially presenting with perforation had poorer recurrence-free survival, higher postoperative complication rates, and longer ICU stays than those who had obstruction.